Q71.13
BillableCongenital absence of upper arm and forearm with hand present, bilateral
Last updated: FY2026 ICD-10-CM (Oct 1, 2025 – Sep 30, 2026) | CMS-HCC V28 (100% phase-in, PY2026)
Is Q71.13 an HCC code?
No. Q71.13 is a billable ICD-10-CM code but does not map to any HCC category in V28, V24, ESRD, or RxHCC.
This code does not map to an HCC category in any model (V28, V24, ESRD, RxHCC).
What This Code Means
Q71.13 is the ICD-10-CM diagnosis code for congenital absence of upper arm and forearm with hand present, bilateral. A congenital condition where both upper arms and forearms are absent from birth, but both hands are present. Q71.13 sits in the ICD-10-CM chapter for congenital malformations, deformations, chromosomal abnormalities, and genetic disorders (q00-qa0), within the section covering congenital malformations and deformations of the musculoskeletal system (q65-q79).
Q71.13 is a billable ICD-10-CM code but does not map to a payment HCC under the CMS-HCC V28, V24, ESRD, or RxHCC risk adjustment models. It can be reported on Medicare Advantage encounter data submissions but it does not contribute to a beneficiary's RAF score and therefore does not affect risk-adjusted payments to the plan.
Bilateral code - confirm documentation explicitly states both sides are affected.
HCC Buddy maintains structured V28 and V24 mapping, RAF weights, and MEAT documentation criteria for Q71.13 sourced directly from the CMS-HCC risk adjustment model files and the CMS ICD-10-CM code set.
Coding Tips
- •Bilateral code - confirm documentation explicitly states both sides are affected
- •This unusual presentation may warrant genetic counseling referral and investigation for associated syndromes